Facility Evaluation Report

At 12:50 pm on this day, October 9, 2025, Licensing Program Analyst (LPA) Delmundo arrived unannounced to conduct an annual required inspection. LPA was granted entry by staff, Lourdita Balba. LPA also met with other staff, Marieta Balilo, and informed the purpose of visit. LPA called and spoke with

Maria Theresa "Tek" Ordiniza, assistant administrator (ADM), who gave permission to Marieta Balilo to be with LPA in touring the facility. There were 3 residents present when LPA arrived, 2 at day program and one with family member. ADM arrived at around 1:10 pm.

LPA started the inspection with Marieta Balilo and continued with ADM. LPA inspected the facility inside and out including but not limited to bedrooms, bathrooms, kitchen, dining and living room. garage, side yard and backyard. There is a supply of 7 days of non-perishable and 2 days of perishable foods. Central storage for medications was observed locked.

Fire extinguisher was observed fully charge with tag showed serviced March 26, 2025. Facility has carbon monoxide and smoke detectors that were tested and observed in operating condition. Hot water temperature in the one of common bathrooms was tested and measured at 117.8 degrees Fahrenheit. Facility conducts fire and earthquake drills every quarter and records showed last conducted September 26, 2025.

LPA reviewed 5 residents and 5 staff files, and interviewed 1 resident. Medications were inspected and compared with doctor's orders and LIC622 Centrally Stored Medication and Destruction Records. P&I/cash resources checked and compared with last recorded balance.